Capsular contracture

Capsular contractures are a potential complication of a breast implant and refers to a tightening and hardening of the capsule that surrounds a breast implant. It is a condition that can distort the shape and cause pain in the augmented breast. It seems to be the commonest complication post-breast augmentation surgery (~17.5%).

Pathology

Grading

The grade of contracture has been classified by Baker as following:

• grade I: the breast is soft (but not the capsule is contracted)
• grade II: the breast looks normal but is rather hard to the touch
• grade III: the breast is hard, there is some distortion due to contracture and the breast becomes rounded shape, or the implant is generally moved upwards
• grade IV: is similar to grade III but with progressive hardening of the capsule

Capsular contracture is a multifactorial condition, for which multiple solutions have been proposed, including alternative implant placement alternative filler material within the shell of the implant and surface texture of the implant.

Radiographic features

Ultrasound

May show thickening of the echogenic fibrous capsule with an increased number of radial folds. An increased anterior-posterior diameter may be seen ¹².